血糖波动联合炎症及免疫因素对糖尿病合并尖锐湿疣患者治疗后复发的影响

Influence of blood glucose fluctuation,inflammation and immune factors on recurrence of condyloma acuminatum in patients with diabetes

目的探讨糖尿病合并尖锐湿疣(DMCA)患者CO_(2)激光及咪喹莫特(CO_(2)-I)治疗后血糖波动联合白介素-6(IL-6)及血清肿瘤坏死因子-α(TNF-α)与复发的相关性。方法纳入2020年8月—2022年12月期间在亳州市人民医院实施CO_(2)-I治疗的136例DMCA患者进行研究,所有患者均在治疗后持续72 h监测血糖水平并计算平均血糖波动幅度(MAGE)。出院后对患者跟踪随访6个月,统计患者短期复发情况,依据治疗后复发情况将患者分为复发组(34例)与非复发组(102例),并分析糖尿病合并CA患者CO_(2)-I治疗后血糖波动对短期复发的影响。结果经统计,136例DMCA患者复发34例,占25.00%,未复发患者共102例,占75.00%。复发组的MAGE、IL-6和TNF-α水平均高于非复发组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,MAGE值高(≥3.9 mmol/L,OR=1.527,P<0.001)、肛门和(或)生殖器区域糜烂(OR=2.786,P=0.016)、TNF-α水平高(≥6.39μg/L,OR=1.746,P=0.001)、IL-6水平低(<5.26 pg/mL,OR=1.725,P=0.001)均为复发的危险因素。结论DMCA患者CO_(2)-I治疗后MAGE、TNF-α越高、IL-6越低,肛门和(或)生殖器区域糜烂,短期复发风险越大,具有一定的临床意义,可能为预后提供评估依据。

ObjectiveThis study aimed to investigate the correlation between blood glucose fluctuations,interleukin-6(IL-6),and serum tumor necrosis factor-alpha(TNF-α)levels following CO_(2)-laser and imiquimod treatment(CO_(2)-I)in patients with diabetes mellitus complicated by anogenital(DMCA),and their association with recurrence rates. MethodsA prospective cohort study was conducted on 136 DMCA patients treated with CO_(2)-I at the People's Hospital of Bozhou,from August 2020 to December 2022.Post-treatment,all patients underwent continuous blood glucose monitoring for 72 hours to calculate the mean amplitude of glycemic excursion(MAGE).After discharge,patients were followed up for six months to evaluate short-term recurrence.Patients were divided into a recurrence group and a non-recurrence group based on their post-treatment recurrence status.The impact of blood glucose fluctuations on short-term recurrence in diabetic patients with condyloma acuminatum(DMCA)following CO_(2)laser treatment(CO_(2)-I)was analyzed. ResultsAmong the 136 DMCA patients,34(25.00%)experienced recurrence,while 102(75.00%)did not.The recurrence group exhibited significantly higher levels of MAGE,IL-6,and TNF-αcompared to the non-recurrence group,with these differences being statistically significant(P<0.05).Multivariate logistic regression analysis indicated that higher MAGE values(≥3.9 mmol/L,OR=1.527,P<0.001),higher incidence of anorectal and/or genital erosion(OR=2.786,P=0.016),elevated TNF-αlevels(≥6.39μg/L,OR=1.746,P=0.001),and decreased IL-6 levels(<5.26pg/mL,OR=1.725,P=0.001)were risk factors for the recurrence.ConclusionIn DMCA patients treated with CO_(2)-I,high MAGE values,increased expression of TNF-αand lower IL-6,and the presence of anorectal and/or genital erosion significantly increase the risk of short-term recurrence.These findings hold certain clinical implications and may provide a basis for prognosis assessment.